Pre-pregnancy
and antenatal care
for women with diabetes mellitus
(General information)
Information for women
Planning a pregnancy?
Planning ahead for pregnancy is important for all, but for women with diabetes we recommend extra care and advice before conception and throughout pregnancy. This will help to ensure a safe and successful pregnancy.
Before you become pregnant
· If possible, blood glucose levels should be kept between 4 to 6 mmol/l before meals and HbA1c should have been stable and as near target as possible for 3months before you stop using contraception.
If your blood glucose is not well controlled in early pregnancy, the risk of stillbirth and miscarriage is increased. It may also affect your baby’s early development.
The target for most women for prepregnancy glycaemic control should be an HbA1c of 42to53mmol/l (around 6 to 7%) for 3months before pregnancy.
· Discuss your current medicines with your diabetes team – you may have to stop or change medicines in preparation for pregnancy (such as medicines for high blood pressure).
· Make sure you are up to date with routine retinal screening.
· Start taking folic acid 5mg each day (you need a prescription for this strength). This helps normal development in the very early weeks of pregnancy.
· Stop smoking. Your diabetes team or GP can refer you to a cessation specialist.
· Eat a healthy and balanced diet. A dietitian is on hand for advice at the specialist clinic.
· Arrange a specialist prepregnancy consultation.
Your specialist care team
At your prepregnancy consultation you will see a specialist team comprising of:
· Obstetrician
· Diabetologist (doctor who specialises in diabetes)
· Dietitian
· Specialist diabetes midwife
· Lab technician
What will happen at a
prepregnancy appointment?
You can discuss any questions you have about diabetic pregnancy and receive advice.
We will test your blood for anaemia, immunity to rubella (German measles), thyroid and kidney function as well as an HbA1c test.
We will offer screening for any complications of your diabetes such as problems with your eyes, feet and kidney function (including microalbumin).
Why should I keep my blood glucose normal?
Early pregnancy
From the time of conception (usually about 2weeks after the first day of your last menstrual period) until about 10weeks, the developing baby is sensitive to very high blood glucose levels. During this time, the major organs are being formed.
Later in pregnancy
If blood glucosesugar is high, your baby can grow larger than normal. This can lead to more difficult birth and may be a reason for needing a caesarean section.
Haemoglobin A1c (HbA1c)
This is a measure of the average blood glucose over the preceding two months or so. Ideally, it should be less than 53mmol/l ( 7%) although this can be challenging to achieve.
Contact telephone numbers
If you have any questions about your health or care, you can call us on:
Diabetic Clinic
Woolmanhill Clinic
( (01224) 555443 (
Antenatal Clinic
Aberdeen Maternity Hospital
( (01224) 552743 (
Useful websites
www.mydiabetesmyway.scot.nhs.uk
Provides information on all aspects of diabetes.
www.dft.gov.uk/dvla/medical
Provides information on medical conditions and driving.
Please note that NHS Grampian is not responsible or liable for the quality of the information, resources or maintenance of external websites. Any advice on external websites is not intended to replace a consultation with an appropriately qualified medical practitioner.
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